Infertility in women - Christina Cherry

Unfulfilled desire to have children

Infertility in women – possible causes

Infertility can have many causes. An illness is not always the cause. And the cause of infertility cannot be determined in every case.

Environmental factors and lifestyle

Severe psychological or physical overload (e.g. competitive sports, heavy physical work), alcohol, smoking, drugs, medication and environmental toxins can have a negative impact on fertility. Overweight and underweight as well as disturbances in eating behavior or diets are not beneficial for fertility. This everything applies to both women and men.

Age

The aging process plays an important role. Even before birth, the number of later available egg cells in the ovaries is fixed. This reservoir of functional egg cells shrinks continuously with increasing age. Many eggs die naturally. Only a small part matures during the cycles to the fertilizable egg cell and the quality of these egg cells takes with age. This process is visibly ended with menopause. But fertility is significantly reduced much earlier [Fig.1].

life planning

Because women nowadays postpone their desire to have children more often to a later phase of life, it increasingly falls on an age segment in which fertility naturally decreases (approx. From 30 years). While in the most fertile age (between 20 and 30 years) education and profession are in the foreground. However, this modern life planning, often referred to as the late desire to have children, increases the likelihood of a fertility disorder.

Medical causes of female infertility

Infertility can be caused by different illnesses. These include disorders in the hormonal balance or diseases of the genital organs. But diseases that do not primarily affect the genital organs can also lead to infertility (e.g. metabolic diseases). It can be genetic (inherited) or acquired (acquired) in the course of life.

The following is a list of the most common diseases in women:

Hormonal disorders

The hormonal balance plays a central role in fertility. Especially the lifestyle factors mentioned can mess it up.

Hormonal disorders often affect egg maturation. This means that, for example, no mature follicle develops, ovulation does not occur, the luteal body does not develop enough or cysts form. Polycystic ovarian syndrome (PCOS) also belongs to this group.

The origin of the hormonal disorder can be central to the brain or the ovary. This means that insufficient signal hormones (GnRH or LH and FSH) are released in the brain, or that the ovaries do not produce enough estrogen or progesterone.

A disturbance in the hormone control loop can also lead to an excess of male hormones (androgens) in women come, which in turn is the cause of other malfunctions (e.g. polycystic ovarian syndrome).

The uterus can also be the cause of a hormonal disorder, namely if the placenta produces too little chorionic gonadotropin (hCG) during pregnancy, which is responsible for maintaining pregnancy.

Not to forget: disorders of thyroid function, insulin balance (diabetes), prolactin levels (hyperprolactinemia), and others are among the hormonal causes that can impair fertility.

Fallopian tube-related disorders

Inflammation, growths (tumors, endometriosis), adhesions (e.g. after operations), and many other disorders can lead to partial or complete occlusion of the fallopian tubes [Fig. 3]. This occurs relatively frequently, in about a third of the cases, as the cause of a fertility disorder.

uterus

Changes in the uterus (uterus) or cervix (cervix) can limit fertility. The causes include inflammation, infections (e.g. venereal diseases), adhesions (e.g. after surgery) and growths (polyps, cysts, fibroids, endometriosis), to name a few examples.

endometriosis

Endometriosis is a progressive disease in which the endometrium settles outside the uterus [Fig. 4]. These mucosal foci develop on the various organs in the abdomen. They can be found, for example, on the ovaries, the bladder, the kidney, the intestine and on the outside of the uterus or fallopian tubes. The symptoms of endometriosis can vary widely. Severe pain during the menstrual period is often described. Endometriosis is relatively common. It is estimated that up to 10% of women of childbearing age and at least a third of women who do not wish to have children are affected.

fibroids

Fibroids are benign tumors of the uterine muscles [Fig. 5]. Depending on the size, number and location of the occurrence, they can also limit fertility.